Why are Men More Likely To Die of Cancer?

June 13, 2016
| by Stephanie Smith

Nils Lindstrom, prostate cancer survivor

For years, Nils Lindstrom watched somewhat passively as a growth on his eyelid grew so large that it started to affect his vision. Still, he avoided going to the doctor. “My kids were bugging me about this thing on my eyelid,” said Lindstrom. “They said ‘Dad, it’s starting to scare your grandchildren.’”

Lindstrom eventually dealt with the growth but says his ambivalence about it sums up his views, back then, about getting medical care: “I think we men have this hero complex thing — ‘I’m tough, I feel good, I’m fine,’” said Lindstrom, who is 62.

We think we’re made of rubber. We think that nothing is going to happen to us.”

When he was later diagnosed with late-stage prostate cancer, that attitude would haunt him.

Men and cancer

Compared to women, men are more likely to be diagnosed with cancer at a later stage — and they have a higher risk of dying. According to the National Cancer Institute, this year approximately 208 per 100,000 men will die of cancer, while 145 out of 100,000 of women will die. The figures are bleaker if you factor in race: African-American men die at a rate of 262 out of 100,000.

Pinning down reasons — for example, sex or socioeconomic differences — does not provide a full explanation for the disparity, but studies offer some clues:

Men are more likely to put off medical checkups and less likely to keep up with things like cancer screening.

When men do schedule medical appointments, they tend to have what researchers describe as a “macho” attitude. These so-called “manly men” prefer male doctors, but are reluctant to divulge symptoms or other details about their health.

‘Hello? We’re in the room, too’

Lindstrom describes himself as a fit, healthy guy who never drank or smoked. But he fits the category of the type of guy who had been lax about cancer screening when he was diagnosed recently with prostate cancer.

“My wife was very good about being screened for breast cancer,” said Lindstrom. “And I just didn’t think I needed to every year. Why every year? What could happen in a year — or two years?”

He says one reason men may not stay on top of screening is awareness. Certain women’s cancers seem to get a big public health and media push compared to campaigns aimed at men.

“Breast cancer is the media darling,” said Lindstrom. “And prostate cancer is like, ‘Hello? We’re in the room, too.’”

Lindstrom tried to comply with testing, getting his first colonoscopy at age 55 (the recommended age for screening is 50) and a test for prostate cancer around 50 (there is no consensus about when and how often this test should be taken). But by his own admission, his follow-ups after testing were not great, in particular when a test in 2012 showed a slightly elevated level of prostate-specific antigen. Lindstrom says his results indicated a PSA level of 5 ng/mL (4 ng/mL and below is normal) but he never thought twice about it and no one followed up with him about it.

It was emotionally traumatic

It was a routine blood test last year — after getting the growth on his eye checked — that clued him in on a simmering problem in his prostate. The test showed his PSA level had soared from 5 to 22. After getting computed tomography and magnetic resonance imaging scans, and later a biopsy, Lindstrom found out his PSA had inched even higher and his prostate was almost completely riddled with cancerous tumors.

“It was emotionally traumatic. I had nightmares,” wrote Lindstrom in a blog about his experience. “Waves of sadness would wash over me, and I would bury my head in my wife’s shoulder and just weep.”

After emerging from the fog of that revelation, Lindstrom had successful surgery with City of Hope surgeon Ali Zhumkhawala, M.D. His cancer is in remission, but in some ways it took something as dramatic as his diagnosis to remind him about the importance of screening — and following up — when it comes to cancer. All of it has resulted in a new attitude about health — and life.

“I have told a lot of people that cancer has been a blessing in disguise,” said Lindstrom. “It cured me of a lot of things — apathy, putting things off in life that I wanted to do. I like who I am better now.”

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This piece is the first in a series about men and cancer. Men are diagnosed with cancer later and have higher death rates than women. During Men’s Health Week and Month, City of Hope is offering tips to make men more aware of their risk and to encourage screening.